Postoperative infections of the spine

Postoperative infections are an unfortunate and potentially devastating complication of routine spinal surgery. While primary prevention is the key, global management consists of perioperative strategies for risk reduction, accurate diagnosis, and careful decision-making for medical versus surgical treatment. When revision surgery is necessary, debridement with or without retention of implants (if present) in concert with administration of antimicrobial agents is indicated. The following section discusses these issues as well as specific operative techniques including adjunctive local antibiotic usage, vacuum-assisted closure, closed suction drainage, and soft tissue reconstruction for more complex wounds.